【摘要】 目的分析樟木头地区近年致儿童肺炎的细菌分布和耐药情况,以提高本地区对儿童细菌性肺炎的诊治水平,减少多重耐药菌的产生和流行。方法统计本院最近3年收治的儿童细菌性肺炎确诊病例,分析致儿童肺炎的细菌分布和耐药情况用于指导临床用药。结果最近3年本院共收治355例儿童细菌性肺炎确诊病例。其中,革兰氏阳性菌感染有54例,占总病例的15.2%(54/355),革兰氏阴性菌感染有301例,占总病例的84.8%(301/355)。在革兰氏阳性菌感染中,多重、双重、单重耐药分别为26、13、13例,仅2例无耐药,耐药率达96.3%(52/54);革兰氏阳性菌主要以葡萄球菌为主,占77.8%(42/54),检出MRSA、MRS菌共11例,占革兰氏阳性多重耐药菌的42.3%(11/26)。在革兰氏阴性菌感染中,多重、双重、单重耐药分别为132、34、128例,仅7例无耐药,耐药率达97.7%(294/301);革兰氏阴性菌主要以肺炎克雷伯菌(ECO)和大肠埃希菌(KPN)为主,占62.5%(188/301),检出产ESBLs菌36例,占革兰氏阴性多重耐药菌的27.3%(36/132),并且已出现亚胺培南耐药的ECO和KPN。结论本地区致儿童肺炎的细菌耐药形式非常严峻,临床医生应加强细菌药敏检测和多重耐药菌监测,合理使用抗菌药物,减少多重耐药菌的产生。更多还原

【Abstract】 Objective To analyze the bacterial distribution and drug resistance on children penumonia in zhang mu tou area in recent years with the aim of improving clinical diagnosis and reduce the spread of multi-drug resistance.Methods For the analysis of the bacterial distribution and drug resistance,Specimens were collected among 2012to2014 and the results were statisticed.Results A total of 355 patients were diagnosed in the past three years,among them 54 patients were Gram-positive infection(15.2%),301 patients Gram-negative infection(84.8%).The number of patients with Multi-drug resistance,double resistance and single resistance was 26,13 and 13respectively in Grampositive infection,and only 2patients had no resistance,the resistance rate is 96.3%.There were 132,34 and 128patients with Multi-drug resistance,double resistance and single resistance in Gram-negative infection,just 7no resistance,the resistance rate is 97.7%.The most common pathogens were Klebsiella pneumonia and Escherichia coli,with the rate 62.5%.In Gram-negative infection,36 samples producing ESBLs accounted for the percentage of 27.3%,Klebsiella pneumonia and Escherichia coli resistance for imipenem had emergenced.Conclusion Drug resistance of children pneumonia is a serious problem in local area,it is important for clinical docters to enhance the diagnosis of multi-drug resistance and reduce the spread of multi-drug resistance.更多还原